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Describes panic disorder and its risks. Discusses types of medicines used to treat panic disorder, as well as reactions to medicines. Covers what to expect if you need them and don't take them. Includes interactive tool to help you make your decision.

Describes panic disorder and its risks. Discusses types of medicines used to treat panic disorder, as well as reactions to medicines. Covers what to expect if you need them and don't take them. Includes interactive tool to help you make your decision.

Panic Disorder: Should I Take Medicine?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

When you have panic
disorder, you have repeated, unexpected panic attacks. And you worry all the
time about having another attack.

A panic attack is a sudden
feeling of very bad anxiety. It may make you feel short of breath or dizzy or
make your heart pound. An attack may last from 5 to 20 minutes or up to a few
hours. You feel most anxious about 10 minutes into the attack.

Personal stories about people deciding whether to take medicine to treat panic disorder

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I was having
lunch with some friends and suddenly began to feel strange—like I couldn't
breathe and my heart was pounding. I didn't know what was happening; I thought
I was having a heart attack. Although the symptoms began to go away after about
10 minutes, I went to the emergency room, where they did some tests and didn't
find anything wrong. A week later, the same thing happened in the middle of the
night. I went to see my doctor, and she suggested I may have had a panic
attack. Since then, the attacks have been occurring at least once a week, and I
have been diagnosed with panic disorder. Although each attack is still a
horrible experience, I now know what is happening and that I will get through
it. I have been going to therapy for several weeks and am learning how to deal
with the symptoms of panic attacks. They are less frequent now and less
intense. I think I can get through this without taking any medicine.

Annie, age
32

As an executive, I have to travel a lot for
my job. A few months ago, I was boarding a plane for a business trip, and I
began to feel very apprehensive. I felt trapped and got off the plane because I
was shaking and sweating and my heart was pounding. I wasn't sure exactly what
was wrong, but I felt like I was dying. I had a drink at the bar and was still
shaky but took a later flight. After that I began to feel nervous if I even
thought about flying, and I had several more similar attacks. Then I had an
attack on the subway. I felt like everyone was watching me and there was no
escape. I didn't even want to go to the office after that because I was afraid
I could have an attack at any moment. My doctor says I have panic disorder and
agoraphobia. I can hardly function, so I am going to take antidepressants and
try exposure therapy. My doctor says a benzodiazepine would make the symptoms
go away sooner. But I am worried they will make me too drowsy and they may be
too hard for me to quit.

Manuel, age 43

When I divorced my wife, Celia, I began to
feel down and very anxious. As a contractor, I have to deal with people every
day, and it seemed very hard to do my job when I felt so stressed out and
depressed. I had my first panic attack when my dog got lost at a job. I knew he
was probably fine and would soon come back, but with the stress of everything
else it just seemed like more than I could handle. I felt awful; I was choking
and had bad stomach cramps. Since then, I have had attacks like this nearly
every day and a lot of the time I feel down in the dumps. I have been diagnosed
with panic disorder and depression. I am going to therapy, and it seems to help
a little, but I still have panic attacks and often feel like life is not worth
living, and I feel anxious about interacting with people at all. At first I
didn't want to take any medicine. But after reading about it and talking it
over with my doctor, I decided to start taking an antidepressant.

Louis, age
28

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take medicines for panic disorder

Reasons not to take medicines for panic disorder

I am willing to take medicine for at least several months, or longer if I need to.

I don't want to take medicines if at all possible.

More important

Equally important

More important

My panic disorder is not improving enough with counseling alone.

I want to continue counseling, without medicine, at least for a while.

More important

Equally important

More important

I think my symptoms may be worse than the possible side effects of the medicine.

I think the side effects of the medicine would be worse than my symptoms.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking medicines

NOT taking medicines

Leaning toward

Undecided

Leaning toward

What else do you need to make your decision?

Check the facts

1.

Taking medicine is the only way I can treat my panic disorder.

TrueSorry, that's not right. Counseling works just as well for many people.

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Panic Disorder: Should I Take Medicine?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the Facts

Your options

Take medicines for panic
disorder.

Don't take medicines. Try home treatment and counseling
to deal with your symptoms.

Key points to remember

Two types of medicines work well for treating panic attacks.
Benzodiazepines can help you feel better right away. You can take
antidepressants for long-term treatment.

Counseling may work just as well as medicines.

If you take
medicines, follow your doctor's directions with care. You may have side effects
such as headaches or trouble sleeping. Some medicines can treat both
depression and panic attacks.

For some
people, taking medicines along with getting counseling works best.

What is panic disorder?

When you have panic
disorder, you have repeated, unexpected panic attacks. And you worry all the
time about having another attack.

A panic attack is a sudden
feeling of very bad anxiety. It may make you feel short of breath or dizzy or
make your heart pound. An attack may last from 5 to 20 minutes or up to a few
hours. You feel most anxious about 10 minutes into the attack.

What are the risks of panic disorder?

Panic
disorder can lower your quality of life. It can get in the way of your daily
life and work. If you have panic disorder, you are more likely to have
other problems, including:

Other treatments include support groups and exercises that
help you relax, such as progressive muscle relaxation or meditation.

Why might your doctor recommend taking medicines?

Your doctor might advise you to take medicines if:

You have not been able to control your
symptoms with other treatment, such as counseling with cognitive-behavioral therapy.

You have other problems linked to
panic disorder that could benefit from medicine, such as
depression or problems with drugs or alcohol.

2. Compare your options

Take medicines for panic
disorder

Don't take medicines

What is usually involved?

For antidepressants, you take
pills or liquids every day or on certain days of the month, for months or
years.

For benzodiazepines, you take pills or liquids as
needed.

You may also try counseling along with taking
medicine.

You try counseling, such as cognitive-behavior therapy, to control your symptoms.

What are the benefits?

Medicines for panic disorder work
well.

Counseling works as well as medicine for many people who have panic disorder.

You don't have
side effects from taking medicine.

What are the risks and side effects?

Medicine may cause
side effects such as:

Nausea.

Headaches.

Nervousness.

Tiredness.

Trouble
sleeping.

Benzodiazepines can lead to addiction.
(Antidepressants do NOT lead to addiction.)

Your panic
disorder may get worse if you have no treatment.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These
personal stories
may help you decide.

Personal stories about people deciding whether to take medicine to treat panic disorder

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I was having lunch with some friends and suddenly began to feel strange—like I couldn't breathe and my heart was pounding. I didn't know what was happening; I thought I was having a heart attack. Although the symptoms began to go away after about 10 minutes, I went to the emergency room, where they did some tests and didn't find anything wrong. A week later, the same thing happened in the middle of the night. I went to see my doctor, and she suggested I may have had a panic attack. Since then, the attacks have been occurring at least once a week, and I have been diagnosed with panic disorder. Although each attack is still a horrible experience, I now know what is happening and that I will get through it. I have been going to therapy for several weeks and am learning how to deal with the symptoms of panic attacks. They are less frequent now and less intense. I think I can get through this without taking any medicine."

— Annie, age
32

"As an executive, I have to travel a lot for my job. A few months ago, I was boarding a plane for a business trip, and I began to feel very apprehensive. I felt trapped and got off the plane because I was shaking and sweating and my heart was pounding. I wasn't sure exactly what was wrong, but I felt like I was dying. I had a drink at the bar and was still shaky but took a later flight. After that I began to feel nervous if I even thought about flying, and I had several more similar attacks. Then I had an attack on the subway. I felt like everyone was watching me and there was no escape. I didn't even want to go to the office after that because I was afraid I could have an attack at any moment. My doctor says I have panic disorder and agoraphobia. I can hardly function, so I am going to take antidepressants and try exposure therapy. My doctor says a benzodiazepine would make the symptoms go away sooner. But I am worried they will make me too drowsy and they may be too hard for me to quit."

— Manuel, age 43

"When I divorced my wife, Celia, I began to feel down and very anxious. As a contractor, I have to deal with people every day, and it seemed very hard to do my job when I felt so stressed out and depressed. I had my first panic attack when my dog got lost at a job. I knew he was probably fine and would soon come back, but with the stress of everything else it just seemed like more than I could handle. I felt awful; I was choking and had bad stomach cramps. Since then, I have had attacks like this nearly every day and a lot of the time I feel down in the dumps. I have been diagnosed with panic disorder and depression. I am going to therapy, and it seems to help a little, but I still have panic attacks and often feel like life is not worth living, and I feel anxious about interacting with people at all. At first I didn't want to take any medicine. But after reading about it and talking it over with my doctor, I decided to start taking an antidepressant."

— Louis, age
28

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take medicines for panic disorder

Reasons not to take medicines for panic disorder

I am willing to take medicine for at least several months, or longer if I need to.

I don't want to take medicines if at all possible.

More important

Equally important

More important

My panic disorder is not improving enough with counseling alone.

I want to continue counseling, without medicine, at least for a while.

More important

Equally important

More important

I think my symptoms may be worse than the possible side effects of the medicine.

I think the side effects of the medicine would be worse than my symptoms.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking medicines

NOT taking medicines

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
Taking medicine is the only way I can treat my panic disorder.

True

False

I'm not sure

You're right. Counseling works just as well for many people.

2.
There are two different kinds of medicines that I can take to help my panic disorder.

True

False

I'm not sure

That's right. Benzodiazepines are taken as needed to help relieve your symptoms. Antidepressants are taken every day for long-term treatment.

Decide what's next

1.
Do you understand the options available to you?

Yes

No

2.
Are you clear about which benefits and side effects matter most to you?

Yes

No

3.
Do you have enough support and advice from others to make a choice?

Yes

No

Certainty

1.
How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2.
Check what you need to do before you make this decision.

I'm ready to take action.

I want to discuss the options with others.

I want to learn more about my options.

3.
Use the following space to list questions, concerns, and next steps.

Credits

By

Healthwise Staff

Primary Medical Reviewer

Anne C. Poinier, MD - Internal Medicine

Specialist Medical Reviewer

Lisa S. Weinstock, MD - Psychiatry

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